Maternal Anemia in Pregnancy: Assessing the Effect of Routine Preventive Measures in a Malaria-Endemic Area

Faculté de Pharmacie, Université Paris Descartes, Paris, France
The American journal of tropical medicine and hygiene (Impact Factor: 2.7). 01/2013; 88(2). DOI: 10.4269/ajtmh.12-0195
Source: PubMed


We investigated the effectiveness of routine preventive measures for anemia in Beninese pregnant women during pregnancy. Anemia (hemoglobin < 110 g/L) was common: 68.3% at first antenatal visit (ANV1), 64.7% at second antenatal visit (ANV2), and 40.6% at delivery. Parasitic infections and nutritional deficiencies were the most preventable causes. After intermittent preventive treatment (IPTp) and antihelminthic treatments, malaria prevalence decreased from 15.1% (ANV1) to 4.0% (ANV2) and increased again to 9.6% at delivery. Helminth infections dropped from 11.1% (ANV1) to 7.2% (ANV2) and 2.4% at delivery. Malaria was associated with lower mean hemoglobin on ANV1 and delivery, and iron deficiency was associated with lower mean hemoglobin on ANV1 and ANV2. IPTp and antihelminthic treatments were efficacious to clear parasitic infections and improve hematologic status, whereas the effectiveness of daily iron and folic acid supplements to correct iron and folate deficiencies and decrease anemia was less marked, possibly because of lack of compliance.

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    • "Primigravidae had a lower mean Hb and an increased risk for anaemia in early pregnancy compared to multigravidae, prior to the administration of IPTp. Furthermore, an overall decrease in the proportion of malaria infections after women were given IPTp has been shown [1,15-17]. In the study, more than 20% of primigravidae were infected by malarial parasites at inclusion, whereas only less than 10% of them were malaria positive at delivery. "
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